一种用于癌症幸存者的造口自我管理远程医疗干预措施：一项随机对照试验的技术相关发现。
An Ostomy Self-management Telehealth Intervention for Cancer Survivors: Technology-Related Findings From a Randomized Controlled Trial.
机构信息
Arizona Telemedicine Program, The University of Arizona Health Sciences, Tucson, AZ, United States.
Hospital of the University of Pennsylvania, Philadelphia, PA, United States.
出版信息
J Med Internet Res. 2021 Sep 27;23(9):e26545. doi: 10.2196/26545.
BACKGROUND
An Ostomy Self-management Telehealth (OSMT) intervention by nurse educators and peer ostomates can equip new ostomates with critical knowledge regarding ostomy care. A telehealth technology assessment aim was to measure telehealth engineer support requirements for telehealth technology-related (TTR) incidents encountered during OSMT intervention sessions held via a secure cloud-based videoconferencing service, Zoom for Healthcare.
OBJECTIVE
This paper examines technology-related challenges, issues, and opportunities encountered in the use of telehealth in a randomized controlled trial intervention for cancer survivors living with a permanent ostomy.
METHODS
The Arizona Telemedicine Program provided telehealth engineering support for 105 OSMT sessions, scheduled for 90 to 120 minutes each, over a 2-year period. The OSMT groups included up to 15 participants, comprising 4-6 ostomates, 4-6 peer ostomates, 2 nurse educators, and 1 telehealth engineer. OSMT-session TTR incidents were recorded contemporaneously in detailed notes by the research staff. TTR incidents were categorized and tallied.
RESULTS
A total of 97.1% (102/105) OSMT sessions were completed as scheduled. In total, 3 OSMT sessions were not held owing to non-technology-related reasons. Of the 93 ostomates who participated in OSMT sessions, 80 (86%) completed their OSMT curriculum. TTR incidents occurred in 36.3% (37/102) of the completed sessions with varying disruptive impacts. No sessions were canceled or rescheduled because of TTR incidents. Disruptions from TTR incidents were minimized by following the TTR incident prevention and incident response plans.
CONCLUSIONS
Telehealth videoconferencing technology can enable ostomates to participate in ostomy self-management education by incorporating dedicated telehealth engineering support. Potentially, OSMT greatly expands the availability of ostomy self-management education for new ostomates.
TRIAL REGISTRATION
ClinicalTrials.gov NCT02974634; https://clinicaltrials.gov/ct2/show/NCT02974634.
背景
护士教育者和同行造口术患者实施的造口自我管理远程医疗（OSMT）干预，可以为新造口患者提供有关造口护理的关键知识。一项远程医疗技术评估旨在衡量远程医疗技术相关（TTR）事件发生时所需的远程医疗工程师支持，这些事件是在使用安全的基于云的视频会议服务 Zoom for Healthcare 进行的 OSMT 干预期间遇到的。
目的
本文研究了在一项针对永久性造口术癌症幸存者的随机对照试验干预中使用远程医疗时遇到的与技术相关的挑战、问题和机遇。
方法
亚利桑那州远程医疗计划在 2 年期间为 105 次 OSMT 会议提供远程医疗工程支持，每次会议计划时长为 90 至 120 分钟。OSMT 组每组最多有 15 名参与者，包括 4-6 名造口术患者、4-6 名同行造口术患者、2 名护士教育者和 1 名远程医疗工程师。研究人员在详细记录中同时记录 OSMT 会议的 TTR 事件。TTR 事件进行了分类和汇总。
结果
97.1%（102/105）的 OSMT 会议按计划完成。共有 3 次 OSMT 会议因非技术相关原因而未举行。在参加 OSMT 会议的 93 名造口术患者中，有 80 名（86%）完成了他们的 OSMT 课程。在已完成的 102 次会议中，有 36.3%（37/102）发生了 TTR 事件，这些事件具有不同程度的干扰影响。没有因 TTR 事件而取消或重新安排会议。通过遵循 TTR 事件预防和事件响应计划，将 TTR 事件的干扰降到了最低。
结论
远程医疗视频会议技术可以通过纳入专门的远程医疗工程支持，使造口术患者能够参与造口自我管理教育。潜在地，OSMT 极大地扩大了新造口患者接受造口自我管理教育的机会。
试验注册
ClinicalTrials.gov NCT02974634；https://clinicaltrials.gov/ct2/show/NCT02974634。
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